POSTNATAL GROWTH OF CRANIOFACIAL STRUCTURES

1. POSTNATAL GROWTH OF
CRANIOFACIAL STRUCTURES
DR.TINET MARY AUGUSTINE. BDS,MDS
PEDIATRIC DENTIST
DR.TINET’S PEDORAYZ, PEDIATRIC AND EARLY AGE
ORTHODONTIC DENTAL CLINIC
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2. CONTENTS
INTRODUCTION
POSTNATAL GROWTH OF
• CRANIAL VAULT
• CRANIAL BASE
• NASOMAXILLARY COMPLEX
• MANDIBLE
• TEMPOROMANDIBULAR JOINT
• ORAL CAVITY
DYNAMICS OF FACIAL GROWTH
CONCLUSION
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3. INTRODUCTION
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4. CRANIAL VAULT
/DESMOCRANIUM
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5. FONTANELLES
6FONTANELLES
Ant-1year post-at birth
Posterolateral-1 ½ years Anterolateral-15months
SUTURES
Frontal =2yrs parietal=3rd decade
occipital=3-4years sphenoid=1year
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6. CRANIAL VAULT
 63% adult size
 Mechanism
• Functional Growth Of Neural Mass
• Apposition At Sutures
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7. FUNCTIONAL
CRANIUM
Growth of neural tissue is almost 8years
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8. Stages of development of sutures(Pritchard ,Scott and Girgis)(AJO
1988)
• Stage of approaching of bony edges
• Stages of meeting of bony edges
• Early growing stage
• Late growing stage
• Adult stage
• neural mass translation tension at suture edges
bone deposition growth
• Sutural ends are smooth at birth serrated as age
advances
• Curvature of bone reduces and become flat
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9. CRANIAL BASE
Lodges neural mass
Provide passage for nerves and blood vessels
Bears the wight of rapidly expanding brain
Provides thrust for anterior growth of facial skelton
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10. CRANIAL FOSSA
Displacement due to expanding neural mass
Growth at synchondrosis
Secondary fill in ossification of sutures
Cortical remodellingDR.TINET MARY AUGUSTINE.BDS MDS
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11. DR.TINET MARY AUGUSTINE.BDS MDS
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12. CRANIAL FOSSA-
GROWTH
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13. SYNCHONDROSIS
Inter sphenoidal(at birth)
Inter occipital(5yr)
Spenoethmoidal(5-10yrs)
Spheno occipital/basioccipita(13-15yrs
Thilander and ingervall 1973 showed that there is a growth catrilage in
the sella turcica which is patent till 3 years of life
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14. SPHENO OCCIPITAL
SYNCHONDROSIS
 MAJOR CONTRIBUTOR IN POSTNATAL GROWTH
 FUSE AT 12-13 IN GIRLS
14-15 IN BOYS
 OSSIFIES AT 20 YEARS
 Central layer of catrilagenous tissue with
proliferating zone
hypertrophic zone
zone of endochondral ossification
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15. CLIVUS
Endocranial portion- resorption
Ectocranial –deposition
Leads to secondary displacement of nasomaxillary complex
Cause vertical growth of middle and lower face
Length of cranial base 65% at birth,83% first year ,98%by 15 years
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16. NASOMAXILLARY
COMPLEX
 Intramembraneous ossification except for nasal catrilage
 Functions(Moyers)
• Airway,Support dentition,Enclose sinus,Smell and air
purification
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17.  Growth takes place in 3planes
• In height
• In transverse direction
• In anterio-posterior direction
 Forces
• Primary displacement
• Synchondroses
• Sutures
• Septal catrilage
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18. DISPLACEMENT
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19. SUTURES

• Zygomaticomaxillary
• Zygomaticotemporal
• Zygomaticofrontal
• Frontomaxillary
• Nasomaxillary
• Frontonasal
• Intermaxillary
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20. SEPTAL CATRILAGE
Nasal septal catrilage grow untill 6years
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21. MAXILLA
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22. ZYGOMATIC BONE
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23. PALATE
Intermaxillary suture is smooth and open in children(6-8)
Overlapping in adolescence(10-12)
Interdigitated in late adolescence(14-16)
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24. ORBIT
Lateral wall-resorption-lateral movemenmt of eyeball
Floor-deposition in superior lateral and anterior direction
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25. OVERALL GROWTH
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26. MANDIBLE
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27. V PRINCIPLE
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28. CONDYLE
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29. ROTATION
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30. INTRA MEMBRANEOUS OSSIFICATION
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31. LINGUAL TUBEROSITY
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32. POSTERIOR
MAXILLARY PLANE
Boundary between important growth controlling functional
matrices
Boundary for growth site of upper and lower jaw
Structural developmental morphological boundary
It makes relating various structures both anatomically and
functionallly
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33. TMJ
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34. ZONES
• Articular zone
• Proliferating zone
• Hypertrophic zone
• Zone of endochondral ossification
• Active proliferation till 13-15yrs. And most evident in
pubertal age
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35. ORAL CAVITY
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36. DYNAMICS OF FACIAL
GROWTH
 PATTERN
 VARIABILITY
 TIMING
 DIFFERENTIAL GROWTH
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37. PATTERN
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38. SCAMMONS CURVE
Maxillary correction is less effective after the age of 10
Facial width follow neural curve and depth and height follow
general body curve
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39. TIMING
Girls complete growth earlier than boys
Skeltal and biological maturity indicators help in assesing
skeltal age of a person
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40. ADRENARCHE
Increase in rise in adrenal androgen and occurs 2 years prior to
start of pubertal acceleration (Parker and Mehesh)
It stimulate gonadrotrophic releasing hormone . Maturation of
gonadostat is important for onset of pubertal spurt(Sizonenko)
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41. CERVICAL
RADIOGRAPH
Bacetti et al stated that peak of mandibular growth is found
to occur within a year after attaining CS3
So CS3-CS4 period yield maximum result
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42. Bacetti and Mc Namara studied result of treatments of
class11 and 111 –excellent result in circumpuertal period
Bacetti et al stated that increase in mandibular length is twice
in circumpubertal than prepubertal
Maxillary expansion will be skeletally effective only if
treatment complete in early adolescence
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43. VARIABILITY
Wetzels grid
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44. GROWTH DIRECTION
• Vertical to horizontal growth of mandible
• Dimension of face complete growth of width followed by depth and
height
• Mand.intercanine width establish by 9-10yrs in boys and
max.canines erupt after mand intercanine width is established
• Max.Width cant increase after 12-13 in girls but max.intercanine
width increase till 18yrs
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45. CONCLUSION
The knowledge of growth and development of craniofacial
structures are necessary to attain a positive result in
orthodontic and orthopedic treatments as they are
specialities that works with the growth
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46. REFERENCE
 Enlow ,Hans .Essentials of facial growth.Wb saunders 1st
edition
 Graber tm .Orthodontics principles and practice.Wb
saunders 3rd edition
 Proffit wr .Contemporary orthodontics .Elsevoer 4th edition
 Baccetti T, franchi L, cameron CG. Treatment timing for
rapid palatal expansion. Ao 2001;71:343-50. 2.
 Baccetti t, franchi l, mcnamara j. An improved version of
cervical vertebra maturation method for the assessment of
mandibular growth. Ao 2002;76:316-23.
 Sperber gh.Craniofacial development . 3rd edition
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47. THANK YOU
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